Discussions By Condition: I cannot get a diagnosis.

Undiagnosed symptoms seriously effecting school

I am a 22 year old female in school full time and work part time, I am generally healthy but do take Yasmin to help with severe PMS.

In October of 2009 I had a kidney infection in which I had an allergic reaction to three different types of antibiotics. I eventually started feeling better but have remained extremely fatigued since then. I went back to the doctor several times but my blood work and urine analysis kept coming up clean. I was then told that I'm tired because of stress and because I have low blood pressure.

However even when I'm not busy or stressed out I'm constantly tired and sometimes need up to 12 hours of sleep just so I can get out of bed. Even if I do get 8 hours of sleep I will wake up in the morning feeling very dizzy and light headed, on a few occasions I have even thrown up. This fatigue has lasted me a few months and things have gotten worse.

About two weeks ago, I started having back and abdominal pain, mostly on my right side and sharp quick pains in my legs, I also began getting splitting headaches in which the only relief I could get would be from sleep. After having a couple drinks on Friday I woke up Saturday morning vomiting all day, (this is not normal for me, as I can usually have a few drinks and be completely fine in the morning) with severe back and abdominal pain to the point where I couldn't stand up. I went to the hospital the next day and they did a urine test and found white blood cells in my urine but said that it didn't mean anything significant and sent me home with some antibiotics for a bladder infection. The antibiotics are helping a little bit, but I still have back pain and am extremely fatigued, it has been four days since I started taking them.

I went to a different doctor earlier this week after the hospital and she found that I have swollen lymph nodes in my neck, which are painless and I am slightly swollen in the abdomen. I then went for an abdominal ultrasound but the results came back normal. I am still waiting for the results of the blood work.

I generally feel unhealthy and know that there's something wrong but even though I've been to many doctors and had several tests done, no one can tell me what's wrong with me. I am in my final year of school and my health has gone so downhill it is severely effecting my schoolwork and I don't know what to do - university profs are generally unsympathetic when you don't know what's wrong with you.

3 Replies:

Many (though not all) of your symptoms are consistent with positional orthostatic tachycardia syndrome (POTS), or something in the family of orthostatic hypotension. POTS, to oversimplify, is when your body isn't able to regulate heart rate and isn't sufficiently able to regulate blood pressure when you stand up or move around. With POTS, your body's blood pressure will drop and your heart rate will rise (in a partially successful attempt to keep your blood pressure up). In orthostatic hypotension, your blood pressure drops and your heart isn't able to maintain blood pressure. Your statement: "even when I'm not busy or stressed out I'm constantly tired and sometimes need up to 12 hours of sleep just so I can get out of bed. Even if I do get 8 hours of sleep I will wake up in the morning feeling very dizzy and light headed, on a few occasions I have even thrown up. This fatigue has lasted me a few months and things have gotten worse" is consistent with POTS. Your statement: "I went back to the doctor several times but my blood work and urine analysis kept coming up clean. I was then told that I'm tired because of stress and because I have low blood pressure" is obviously consistent with POTS or orthostatic hypotension. Your statement: "I had a kidney infection in which I had an allergic reaction to three different types of antibiotics. I eventually started feeling better but have remained extremely fatigued since then" is not inconsistent with POTS. For some reason, many cases of POTS seem to be triggered by an infection and the use of antibiotics to address it. Your statement: "I have swollen lymph nodes in my neck, which are painless and I am slightly swollen in the abdomen. I then went for an abdominal ultrasound but the results came back normal" also isn't inconsistent with POTS. POTS appears to be part of a larger problem with the body unable to fully control various autonomic nervous systems. A relative of mine who ultimately was diagnosed with POTS had severe stomach and digestive problems. His body was having difficulty with the usually-normal process of digesting and processing food. Ask your doctor for tests to determine whether you have orthostatic hypotension or POTS. The "gold standard" is a tilt-table test. POTS won't show up in any blood tests or metabolic panels. There are also some things he/she may tell you to do. One partial solution is to drink lots more fluids. You may also be told to take salt pills. If that doesn't work, there's medication to help you retain fluids. (Sorry: I can't imagine that helping your PMS.) The idea, simply, is that you're increasing your liquid/blood volume, so that a drop in blood pressure won't have as much of an effect. Some doctors who are experts in POTS may also recommend dietary supplments to improve the adrenal function. That's a bit more "out there," but the supplements themselves aren't dangerous. It also helps to just take it very easy for awhile. Let your body try to heal itself. Physical exertion at that point isn't the best thing. Anyhow, get started by getting a referral to a doctor familiar with orthostatic hypotension and POTS. Hope that helps.